| NPI | 1154477065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL WAYNE PASCHALL Owner 719-269-1142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CO 5795) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CO 6141) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2022-07-13 |